AB1019 ANALYSIS OF DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF ENTEROPATHIC SPONDYLOARTHRITIS IN A TERTIARY CARE HOSPITAL
Authors: P. Pérez-García, I. González Fernández, J. Ordas Martínez, C. Sieiro Santos, C. Álvarez Castro, C. Moriano, M. E. Vallejo Pascual, E. Diez Álvarez
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Enteropathic spondyloarthritis (eSpA), is a type of inflammatory joint disease that is related to inflammatory bowel diseases (IBD). Both spondyloarthritis (SpA) and IBD share clinical, genetic and immunological features. Arthritis can occur before, during or after IBD. The treatment of this disease is based on the use of NSAIDS and corticoids as well as the use of csDMARDs and bDMARDs. <h3>Objectives</h3> To describe the demographic, clinical and serological characteristics, as well as the onset pattern, radiological involvement, smoking habit, activity disease and comorbidities such as cardiovascular risk factors (CVRF) in patients with eSpA. To analize the most commonly used drugs in these patients and the therapeutic response. <h3>Methods</h3> We performed a descriptive observational study of patients with eSpA diagnosed in the Hospital of León between 1980 and 2022. The variables analysed were sex, date onset of IBD and SpA, time between the two diagnoses, pattern of SpA involvement, type of IBD, HLAB27, toxic habits, family history, arthralgias, uveítis, psoriasis, dactylitis, radiological involvement (sacroilitis, syndesmophytes) and treatments received. The activity disease was assessed by BASDAI Index. <h3>Results</h3> The patient´s features are shown in Table 1. We included 56 patients, half men and half women. The 57,1% of the cases debut with IBD. Crohn's Disease (CD) was the most represented IBD. The 41,1% had a peripheral SpA (16,1% oligoarticular arthritis and 25% polyarticular arthritis); the 32,1% patients presented an axial SpA and 26,8% had a mixed pattern. Peripheral SpA was the most represented form. The time elapsed between joint involvement and IBD was &lt; 5 years in the 50% of the sample analyzed. HLAB27 was positive in 28,6% of the sample and the 35,7% showed BASDAI &gt; 4. We found associated uveitis and psoriasis in 14,3% and 16,1% of the cases. The 57,1% of eSpA had CVRF, the most prevalent was dyslipemia (39,3%). The 53,6% had radiological involvement (sacroilitis 48.2%, syndesmophytes 21.4%). Radiological involvement was significantly greater in smoker patients (p=0.003), probably due to higher associated inflammatory activity. 78.6% of SpA were treated with cDMARDs and methotrexate was the most used (51.8%), followed by azathioprine, 5-ASA, and leflunomide. 73.2% of the cases received bDMARDs and anti-TNF was the most used (73.2%), followed by IL12-23 inhibitors, JAK inhibitors and anti-integrin. The most frequent cause of discontinuation of methotrexate was side effects (16.1%), especially digestive intolerance; while in patients treated with anti-TNF was secondary failure (19.6%) <h3>Conclusion</h3> In our study, most patients with enteropathic spondyloarthritis first presented intestinal symptoms. The most frequent patterns were peripheral spondyloarthritis and Chron's disease, and we found HLA B27+ in around a third of the sample. Smoking was associated with greater radiological involvement in the form of sacroiliitis and syndesmophytes. Multidisciplinary work between gastroenterology and rheumatology is essential for the diagnosis and treatment of enteropathic spondyloarthritis. These results are consistent with the literature. <h3>Reference</h3> [1]Picchianti-Diamanti A, Lorenzetti R, Chimenti MS, et al. Enteropathic spondyloarthritis: Results from a large nationwide database analysis. Autoimmun Rev. 2020 Feb;19(2):102457. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.